Healthcare Provider Details

I. General information

NPI: 1598608457
Provider Name (Legal Business Name): ROBERT JOHN MONROE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

IV. Provider business mailing address

8917 AMERIGO AVE
ORANGEVALE CA
95662-4611
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-2518
  • Fax:
Mailing address:
  • Phone: 916-425-4788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0116042396
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: